Mortality of septic shock patients is associated with impaired mitochondrial oxidative coupling efficiency in lymphocytes : a prospective cohort study

Background: Septic shock is a life-threatening condition that challenges immune cells to reprogram their mitochondrial metabolism towards to increase ATP synthesis for building an appropriate immunity. This could print metabolic signatures in mitochondria whose association with disease progression and clinical outcomes remain elusive. Method: This is a single-center prospective cohort study performed in the ICU of one tertiary referral hospital in Brazil. Between November 2017 and July 2018, 90 consecutive patients, aged 18 years or older, admitted to the ICU with septic shock were enrolled. Seventy-five patients had Simplified Acute Physiology Score (SAPS 3) assessed at admission, and Sequential Organ Failure Assessment (SOFA) assessed on the first (D1) and third (D3) days after admission. Mitochondrial respiration linked to complexes I, II, V, and biochemical coupling efficiency (BCE) were assessed at D1 and D3 and Δ (D3–D1) in isolated lymphocytes. Clinical and mitochondrial endpoints were used to dichotomize the survival and death outcomes. Our primary outcome was 6-month mortality, and secondary outcomes were ICU and hospital ward mortality. Results: The mean SAPS 3 and SOFA scores at septic shock diagnosis were 75.8 (± 12.9) and 8 (± 3) points, respectively. The cumulative ICU, hospital ward, and 6-month mortality were 32 (45%), 43 (57%), and 50 (66%), respectively. At the ICU, non-surviving patients presented elevated arterial lactate (2.8 mmol/L, IQR, 2–4), C-reactive protein (220 mg/L, IQR, 119–284), and capillary refill time (5.5 s, IQR, 3–8). Respiratory rates linked to CII at D1 and D3, and ΔCII were decreased in non-surviving patients. Also, the BCE at D1 and D3 and the ΔBCE discriminated patients who would evolve to death in the ICU, hospital ward, and 6 months after admission. After adjusting for possible confounders, the ΔBCE value but not SOFA scores was independently associated with 6-month mortality (RR 0.38, CI 95% 0.18–0.78; P = 0.009). At a cut-off of − 0.002, ΔBCE displayed 100% sensitivity and 73% specificity for predicting 6-month mortality. Conclusions: The ΔBCE signature in lymphocytes provided an earlier recognition of septic shock patients in the ICU at risk of long-term deterioration of health status

Mate (Ilex paraguariensis) as an etiological agent of neoplasia in the aerodigestive tract an experimental study

Existem estudos que consideram o “chimarrão” como fator de risco para desenvolvimento do câncer de orofaringe, esôfago e laringe (infusão de erva mate, Ilex paraguariensis). Comparar a histologia do trato aéro-digestivo de ratos submetidos ao consumo de erva mate Ilex paraguariensis, com um grupo controle. Setenta e cinco ratos Wistar adultos foram testados, 60 bebendo mate na temperatura ambiente e 15 bebendo água (grupo controle), durante 5 meses. A histologia do trato aéro-digestivo destes animais foi analisada. Os animais apresentaram alterações nos exames anátomo-patológicos havendo diferença significativa (p=0,02) entre os que tomaram mate e o grupo controle. Houve diferença estatística entre o peso corporal dos grupos em estudo e o grupo controle (p<0,001). Este estudo indica que o consumo de mate afeta o trato aerodigestivo superior e é responsável pela perda de peso dos animais estudados.There are studies that consider drinking “chimarrão” (an infusion of mate, Ilex paraguariensis) a risk factor for developing oropharynx, esophagus and larynx cancer. To make a histological comparison between the aerodigestive tracts of a group of rats submitted to the consumption of erva-mate Ilex paraguariensis, with a control group. Seventy-five adult Wistar rats were tested, 60 drinking mate at room temperature and 15 drinking water (control group), during a period of 5 months. The histology of the aerodigestive tracts of these animals was analyzed. The animals presented alterations in the anatomical-pathological exams. There was a significant difference (p=0.02) between those that were given mate and the control group. There is evidence to suggest that the consumption of mate affects the upper aerodigestive tract in the animals studied, but not inducing cancer

Alterações de peso em ratos em estudo sobre o potencial carcinogênico da erva mate (ilex paraguariensis) no trato digestivo e urinário

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Alterações de peso em ratos em estudo sobre o potencial carcinogênico da erva mate (ilex paraguariensis) no trato digestivo e urinário

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